Liu Hui, Jiang Xia, Qiao Qiaohua, Chen Liying, Matsuda Koichi, Jiang Guangyi, Yu Tunan, Wang Yifan, Lin Hui, Liang Xiao, Cai Xiujun
Zhejiang Provincial Key Laboratory of Laparoscopic Technology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Ann Transl Med. 2020 Sep;8(17):1080. doi: 10.21037/atm-20-1637.
Vitamin D plays a key role of anti-cancer process, however, the association of vitamin D level and its related genetic variants with hepatocellular carcinoma (HCC) risk and prognosis is not fully understood.
We enrolled 100 HCC patients and 8,242 health controls from Sir Run Run Shaw Hospital. Logistic regression model was used to calculate the odds ratio (OR) and 95% CI for HCC risk according to serum 25(OH)D concentration. Mendelian randomization (MR) approach was also conducted to validate the potential causal association of 25(OH)D with HCC risk. Hazard ratio (HR) for the association of SNPs with overall survival and disease-free survival was assessed by multivariate Cox hazard proportional regression model.
Plasma 25(OH)D level greater than 20 ng/mL increased HCC risk (OR =7.56, 95% CI: 4.58-12.50). MR analysis also showed a slightly increased risk of HCC by 25(OH)D increasing, yet did not reach statistical significance (OR =1.03, 95% CI: 0.31-3.47). With regard to HCC survival, compared to patients with rs8018720 GG genotype, patients with rs8018720 CC/CG genotype had a longer disease-free survival time (HR =0.39, 95% CI: 0.18-0.81). There was an interaction between rs12785878 and 25(OH)D level in continuous scale for HCC mortality. An interaction between rs12785878 and dichotomized 25(OH)D concentration for disease-free survival of HCC patients was also confirmed.
There is hazard of circulating 25(OH)D concentration for HCC occurrence, but protective effect of the interaction between circulating 25(OH)D concentration and its related genetic variation for HCC prognosis. Further study is needed to confirm or refute these findings in a larger population.
维生素D在抗癌过程中起关键作用,然而,维生素D水平及其相关基因变异与肝细胞癌(HCC)风险和预后的关联尚未完全明确。
我们纳入了来自邵逸夫医院的100例HCC患者和8242名健康对照。采用逻辑回归模型根据血清25(OH)D浓度计算HCC风险的比值比(OR)和95%置信区间(CI)。还采用孟德尔随机化(MR)方法验证25(OH)D与HCC风险的潜在因果关联。通过多变量Cox风险比例回归模型评估单核苷酸多态性(SNP)与总生存期和无病生存期关联的风险比(HR)。
血浆25(OH)D水平大于20 ng/mL会增加HCC风险(OR = 7.56,95% CI:4.58 - 12.50)。MR分析也显示随着25(OH)D升高HCC风险略有增加,但未达到统计学显著性(OR = 1.03,95% CI:0.31 - 3.47)。关于HCC生存情况,与rs8018720 GG基因型患者相比,rs8018720 CC/CG基因型患者的无病生存期更长(HR = 0.39,95% CI:0.18 - 0.81)。在HCC死亡率的连续量表中,rs12785878与25(OH)D水平之间存在相互作用。在HCC患者的无病生存期方面,rs12785878与二分的25(OH)D浓度之间的相互作用也得到了证实。
循环25(OH)D浓度对HCC发生存在风险,但循环25(OH)D浓度与其相关基因变异之间的相互作用对HCC预后具有保护作用。需要进一步研究在更大规模人群中证实或反驳这些发现。